High-sensitivity cardiac troponin I as a reliable prognosis biomarker in patients with hypertrophic cardiomyopathy

Abstract

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease and is associated with increased risk of cardiovascular events. For risk assessment, guidelines recommend carrying out different tests during follow-up. However, the role of plasma biomarkers such as serum high-sensitivity cardiac troponin- I (hs-cTnI) has not yet been well established. To get more data, we analyzed the relationships between this biomarker and clinical and imaging parameters. METHODS: We performed a retrospective study based on the review of data of HCM patients with at least one hs-cTnI measurement in our center and compared the clinical profiles of patients with and without hs-cTnI elevation. In case of several measurements, the highest hs-cTnI value was considered. RESULTS: Out of 98 patients, 52% presented elevated hs-cTnI. Median level of ambulatory measurements was 17 ng/mL. Maximum left-ventricle (LV) hypertrophy was mainly basal-septal or septal, with a mean value of 18 mm. Late gadolinium enhancement was mainly intramyocardial. During follow-up, 37 patients developed at least one cardiovascular complication. 75 patients had at least one ambulatory hs-cTnI measurement, out of which 15 had more than one measurement. Significant differences between measurements occurred in 5 (33%) out of these 15 patients. The presence of elevated ambulatory hs-cTnI levels was significantly associated with a reduced LV ejection fraction (LVEF) (p=0,006) and an increased maximum LV wall thickness (p=0,044). CONCLUSIONS: In our study, elevated ambulatory hs-cTnI was associated with both reduced LVEF and increased maximum LV wall thickness. The availability of baseline hs-cTnI levels may help in stratifying the risk of HCM patients.